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And there could be another surge in the weeks ahead, said Dr. Sheila Pinette, director of the Maine CDC.

“The one thing we know about the flu is that it’s unpredictable, so people should get their vaccines if they have not,” Pinette said.

So far this season, the flu has killed 20 children nationwide, including one in Maine last month, a 6-year-old girl from Benton.

Maine doesn’t track the number of adults who die from the flu because there is no reporting requirement, but Pinette said adults certainly have died this year.

Neighboring New Hampshire, which does track flu deaths, reported its 20th of the season on Thursday.

Although individual flu cases don’t have to be reported in Maine, facilities such as schools and nursing homes are required to report outbreaks, and have reported 125 this season.

Hospitals have been inundated with patients with flu symptoms, in emergency rooms and walk-in clinics. Many patients are being admitted to the hospitals.

Sue Hadiaris, chief planning officer at Southern Maine Medical Center in Biddeford, said the hospital’s admittance rate is about 40 percent higher than normal this month.

Josh Francis, director of emergency management at Maine Medical Center in Portland, said the volume there is high as well.

“One major thing we’re doing now is limiting visitors,” he said. “We have signage at every door, and in some areas, like the pediatric unit and the (neonatal intensive care unit), we’re not letting anyone under the age of 12 in.”

Kathy Knight, director of emergency preparedness for Brewer-based Eastern Maine Healthcare Systems and its seven affiliated hospitals, said there has been a noticeable surge in patients in the past couple of weeks directly related to the flu.

She said hospitals have done a great job dealing with the influx, largely because they have detailed plans that were created during the H1N1 flu scare in 2009-10.

Despite reports of a shortage of flu vaccine, Pinette said it’s more about timing than supply.

This year’s vaccine is 52 percent effective, and Pinette said it’s not too late to get vaccinated.

Joe Bruno, who owns Community Pharmacies, a chain in southern Maine, said his pharmacies are well stocked now, but the vaccine goes fast.

“The real problem is if distributors are running out,” he said. “People may have to call around to find a vaccine.”

Rite Aid pharmacies, which operate in dozens of locations in Maine, bought an extra 400,000 flu shots this week to meet increased demand.

Kristin Harris, a pharmacist at the Rite Aid on Forest Avenue in Portland, said there has been a rush of customers seeking flu shots in the past two weeks.

“We’ve recently restocked, so our supply is good,” she said, “but even if people come in and we don’t have supplies, we take their names or send them to another location.”

Justin Ehringhaus of Portland got a flu shot from Harris on Thursday. The 19-year-old Bowdoin College freshman is on winter break and his parents encouraged him to get vaccinated.

“I’ve never gotten one before, but it seemed like things were bad this year,” he said.

Professors at Bowdoin told Ehringhaus and other students that if they have the flu, they should wait before going back to school.

Tina Veilleux, nurse coordinator for Portland’s public schools, said Portland has fared well so far.

“We haven’t reached the 15 percent absent rate, which would trigger a report to the CDC,” she said. “But things have definitely peaked in the last week or two.”

The city of Portland will host a free clinic from 10 a.m. to 2 p.m. Friday at City Hall. The city’s clinic on India Street offers free flu shots on a walk-in basis every weekday.

This year’s flu season has been compounded by high rates of other respiratory illnesses, along with increased prevalence of norovirus. Some people have mistaken other viruses for the flu.

The hardest part, health officials said, is stopping the flu from spreading. Many people who are sick are reluctant to take multiple days off work or school, and when they do show up, others suffer, Pinette said.

Carolyn Beem, spokeswoman for L.L. Bean, one of Maine’s largest employers, said the company has not been hit hard by the flu.

More than half of L.L. Bean’s employees took advantage of free flu shot clinics in the fall, and the company strongly advocates that people stay at home if they are sick, even if that does go against what Beem called “the traditional Maine work ethic.”

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